A simple model to predict bacteremia in women with acute pyelonephritis

Kim, Kyung Soo; Kim, Kyuseok; Jo, You Hwan; Kim, Tae Yun; Lee, Jin Hee; Lee, Se Jong; Rhee, Joong Eui; Suh, Gil Joon

doi:10.1016/j.jinf.2011.06.007

Cited by 32 publications

(32 citation statements)

References 17 publications

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“…Blood culture identified the urinary pathogen in 60 of 645 (9.3%) patients, and 15 of 645 patients (2.3%) changed the antibiotic regimen after confirmation of blood culture results. The incidence of bacteremia (42.7%) in the current study [5] is slightly higher than that in other studies (19-23%) [3467]. The positive pathogen detection rate (69.3%) in urine culture was lower than that of other studies (74-98%) [346].…”

contrasting

confidence: 71%

Overuse of Diagnostic Testing in the Management of Korean Patients with Acute Pyelonephritis

Park

2017

Infect Chemother

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contrasting

confidence: 71%

Overuse of Diagnostic Testing in the Management of Korean Patients with Acute Pyelonephritis

Park

2017

Infect Chemother

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“…Only a few studies have prospectively analyzed the relationship between chills and bacteremia [3,4,[6][7][8][9]28], and none of them have included all patients at the ED where a blood culture had been obtained. Several studies have tried to develop clinical prediction rules to calculate the risk of bacteremia in patients seeking health care with suspected infection [3,4,[11][12][13][14][15][16][18][19][20][21][22][23]. The proposed clinical prediction rules contain between 6 and 20 variables, including clinical parameters, laboratory results, and anamnestic data.…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, it is important at the population level to identify patients who do not have a bacterial infection to avoid unnecessary use of antibiotics. Other investigators have developed clinical prediction rules for the risk of bacteremia in patients with suspected infection [3,4,[11][12][13][14][15][16][17][18][19][20][21][22][23]. However, these studies have yielded conflicting results.…”

Section: Introductionmentioning

confidence: 99%

Risk of bacteremia in patients presenting with shaking chills and vomiting - a prospective cohort study

et al. 2020

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Chills and vomiting have traditionally been associated with severe bacterial infections and bacteremia. However, few modern studies have in a prospective way evaluated the association of these signs with bacteremia, which is the aim of this prospective, multicenter study. Patients presenting to the emergency department with at least one affected vital sign (increased respiratory rate, increased heart rate, altered mental status, decreased blood pressure or decreased oxygen saturation) were included. A total of 479 patients were prospectively enrolled. Blood cultures were obtained from 197 patients. Of the 32 patients with a positive blood culture 11 patients (34%) had experienced shaking chills compared with 23 (14%) of the 165 patients with a negative blood culture, P = 0.009. A logistic regression was fitted to show the estimated odds ratio (OR) for a positive blood culture according to shaking chills. In a univariate model shaking chills had an OR of 3.23 (95% CI 1.35–7.52) and in a multivariate model the OR was 5.9 (95% CI 2.05–17.17) for those without prior antibiotics adjusted for age, sex, and prior antibiotics. The presence of vomiting was also addressed, but neither a univariate nor a multivariate logistic regression showed any association between vomiting and bacteremia. In conclusion, among patients at the emergency department with at least one affected vital sign, shaking chills but not vomiting were associated with bacteremia.

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“…Fifteen publications [2,8,[14][15][16][17][18][19][20][21][22][23][24][25][26], conducted from 1990 through 2014 and including 59 276 patients, were included in the review ( Table 1). All were published in journals; two were in Spanish [18,23] and the rest were in English.…”

Section: Description Of Included Studiesmentioning

confidence: 99%

Predicting bacteraemia in validated models—a systematic review

Eliakim‐Raz

Bates

Leibovici

2015

Clinical Microbiology and Infection

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Bacteraemia is associated with high mortality. Although many models for predicting bacteraemia have been developed, not all have been validated, and even when they were, the validation processes varied. We identified validated models that have been developed; asked whether they were successful in defining groups with a very low or high prevalence of bacteraemia; and whether they were used in clinical practice. Electronic databases were searched to identify studies that underwent validation on prediction of bacteraemia in adults. We included only studies that were able to define groups with low or high probabilities for bacteraemia (arbitrarily defined as below 3% or above 30%). Fifteen publications fulfilled inclusion criteria, including 59 276 patients. Eleven were prospective and four retrospective. Study populations and the parameters included in the different models were heterogeneous. Ten studies underwent internal validation; the model performed well in all of them. Twelve performed external validation. Of the latter, seven models were validated in a different hospital, using a new independent database. In five of these, the model performed well. After contacting authors, we found that none of the models was implemented in clinical practice. We conclude that heterogeneous studies have been conducted in different defined groups of patients with limited external validation. Significant savings to the system and the individual patient can be gained by refraining from performing blood cultures in groups of patients in which the probability of true bacteraemia is very low, while the probability of contamination is constant. Clinical trials of existing or new models should be done to examine whether models are helpful and safe in clinical use, preferably multicentre in order to secure utility and safety in diverse clinical settings.

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A simple model to predict bacteremia in women with acute pyelonephritis

Cited by 32 publications

References 17 publications

Overuse of Diagnostic Testing in the Management of Korean Patients with Acute Pyelonephritis

Overuse of Diagnostic Testing in the Management of Korean Patients with Acute Pyelonephritis

Risk of bacteremia in patients presenting with shaking chills and vomiting - a prospective cohort study

Predicting bacteraemia in validated models—a systematic review

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